title: Effects of sex steroids on plasma total homocysteine levels: a study in transsexual males and females.
abstract: Plasma total homocysteine (tHcy) levels are higher in men vs. premenopausal women, but it is not known whether this difference is related to sex steroids. The effects of cross-sex hormone administration on plasma tHcy levels were therefore investigated. Plasma tHcy levels were measured at baseline and after 4 months of treatment in 17 male-to-female (M-->F) transsexuals treated with ethinyl estradiol (100 micrograms/day), in combination with the antiandrogen, cyproterone acetate (100 mg/day), and in 17 female-to-male (F-->M) transsexuals treated with testosterone esters (250 mg/2 weeks, im). In M-->F transsexuals, the plasma tHcy level decreased from geometric mean 8.2 mumol/L to 5.7 mumol/L (P < 0.001); and in F-->M transsexuals, it increased from 7.7 mumol/L to 9.0 mumol/L (P = 0.005). In M-->F transsexuals, changes in serum sex hormone-binding globulin levels correlated negatively, and changes in plasma creatinine and albumin levels correlated positively, with changes in plasma tHcy levels. In F-->M transsexuals, changes in serum 17 beta-estradiol levels correlated negatively, and changes in plasma creatinine levels correlated positively, with changes in plasma tHcy levels. We conclude that tHcy levels decrease after estrogen + antiandrogen administration to male (transsexual) subjects, and levels increase after androgen administration to female (transsexual) subjects. These changes may be both primary and secondary to the anabolic/catabolic effects, as reflected by changes of creatinine and albumin levels after cross-sex hormone administration.
authors.affiliation: Department of Endocrinology, Division of Andrology, Hospital Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: Giltay
authors.forename: E K
authors.initials: EK
authors.lastname: Hoogeveen
authors.forename: J M
authors.initials: JM
authors.lastname: Elbers
authors.forename: L J
authors.initials: LJ
authors.lastname: Gooren
authors.forename: H
authors.initials: H
authors.lastname: Asscheman
authors.forename: C D
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage; D003404:Creatinine / Q000097:blood; D017373:Cyproterone Acetate / Q000008:administration & dosage; D004958:Estradiol / Q000097:blood; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D012739:Gonadal Steroid Hormones / Q000494:pharmacology*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D012709:Serum Albumin / Q000378:metabolism; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000008:administration & dosage; D014189:Transsexualism / Q000097:blood*
chemical_list: D000726:Androgen Antagonists; D012739:Gonadal Steroid Hormones; D012709:Serum Albumin; D012738:Sex Hormone-Binding Globulin; D006710:Homocysteine; D013739:Testosterone; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D004958:Estradiol; D003404:Creatinine